Account Follow-Up Representative I

 

·         Timely follow-up on hospital patient accounts that are outstanding for insurance payment, including but not limited to the following processes: verify claim payment status, rebill to patient’s insurance, proration to correct financial class and notation of patient accounts with steps taken for resolution

·          Work an average of 30-40 patient accounts per workday for assigned payor(s)

·          Assigned Payor denials and Zero ($0) pay reports worked within 48 hours of receipt

·         Communicate effectively with insurance companies for payment of outstanding insurance balances

·         Understanding of the next steps needed to reach a resolution of outstanding insurance balance

·          Perform research on patient accounts with outstanding insurance balances and route patient accounts through appropriate workflows

·          Completes timely follow-up on assigned accounts, documents research findings in detail and notate next steps towards resolution

·          Review and recommend adjustments on accounts in accordance with payor and client guidelines

·          Participate in and complete projects assigned by team lead or manager to fulfill clients’ contractual agreement of services

·          Work in partnership with other teams/departments regarding resolution of project issues, concerns, and workflows

·          Ability to prioritize job responsibilities and manage time effectively for completion of assignments

·          Complete role-based education and assigned learning courses by the designated deadlines

·          Maintain the effectiveness and implementation of the MEDHOST Quality Management System and meet applicable regulatory requirements as needed

·          Responsible for QMS procedures listed in QMS Procedure Crosswalk found in QMS Manual as applicable.

·          Assist with other assignments as needed

·          Performs other duties as assigned

 


* undefined

Administrative Duties:

·          Accurately input/submit worked time by the required departmental deadlines

·          Maintain basic knowledge of insurance payors and collection regulations

·         Maintain basic industry knowledge through self-study and by attending training classes

·         Attend and participate in team and departmental meetings

·          Effectively responds to emails, telephone calls, voicemails, Microsoft Teams messages, and correspondence from patients, agencies, and facilities in a timely manner  

·         Adherence to all HIPAA Privacy and Security requirements and responsibilities  

·          Perform duties and responsibilities in a positive manner that upholds company policies and procedures